Double vision requires medical attention (12-10-99)

Diplopia, the medical term for seeing double, could be an indicator of a serious condition requiring immediate medical attention.

"The serious causes that raise the red flag are thyroid disease, head trauma, multiple sclerosis, myasthenia gravis and diabetes," says Edward J. Zayac, instructor in the Department of Ophthalmology at The University of Texas Health Science Center at San Antonio. "Diplopia is common among diabetics because of poor circulation in the eye muscles."

Diplopia occurs in two forms, monocular and binocular. In monocular diplopia, one eye sees a double image. In the binocular form, the eyes are misaligned and see two separate images. Binocular diplopia is more common.

Children as well as adults are susceptible to diplopia. "Infants and children adjust to seeing double by ignoring one of the images or suppressing," says Dr. Zayac. "Unfortunately, this is not always good because it will lead to amblyopia, also called ‘lazy eye.’ Adults, on the other hand, cannot suppress an image in most cases and constantly see two images."

Treatment of diplopia is determined by the root cause. "In the
more severe cases, we treat the underlying cause. Normally these cases
are referred to neurologists, neuro-ophthalmologists and other specialists," says Dr. Zayac. In some cases of alignment problems, Dr. Zayac recommends using prisms in eyeglasses to redirect light, establishing single vision.

Surgery, if necessary, is usually successful in repositioning one or more of the six muscles that support the eye, Dr. Zayac says. Diplopia won’t go away on its own, so the sooner medical attention is sought, the better, he adds.